Theory-guided eHealth literacy support for tele-pulmonary rehabilitation in older adults with chronic obstructive...

This study aimed to develop and evaluate theory-guided eHealth literacy support for tele-pulmonary rehabilitation (PR) in older adults with chronic obstructive pulmonary disease (COPD).

Sixty-five COPD patients in the intervention group received an eHealth literacy intervention guided by self-regulated learning model and self-efficacy theory (SRL-SEe PR group), while 65 control patients received an eHealth literacy intervention guided by the self-efficacy theory (SEe PR group). Both groups (n = 130) received interventions for 8 weeks, followed up for 4 weeks, and received tele-PR simultaneously. The primary outcome was eHealth literacy, and the secondary outcomes were technophobia, aging attitudes, online learning self-efficacy, exercise self-efficacy, online SRL ability, symptom burden, and knowledge.

There were statistically significant differences in the eHealth literacy level (MD = 4.03; P < 0.001), technophobia level (MD = -8.08; P < 0.001), attitude toward aging (MD = 14.17; P < 0.001), online learning self-efficacy (MD = 10.80; P < 0.001), exercise self-efficacy (MD = 13.79; P < 0.001), online SRL ability (MD = 8.60; P < 0.001), and COPD knowledge (MD = 2.19; P < 0.001). No statistically significant differences in symptom burden were noticed between the two groups (P > 0.05).

The SRL-SEe PR intervention is feasible and effective. This suggests that eHealth literacy interventions should not only focus on building individuals' learning confidence but also on teaching learning methods and health knowledge that patients are concerned about. These strategies can enhance self-efficacy, leading to better learning outcomes and higher eHealth literacy levels. Future tele-chronic disease management programs should start with disease-specific knowledge and skills, and carry out eHealth literacy training.